Normal-weight nutrition and exercise counselors report feeling significantly more successful in getting their obese patients to lose weight than those who are overweight or obese, a study shows. The findings suggest that patients may be more receptive to those who "practice what they preach."

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A new study by researchers at the Johns Hopkins Bloomberg School of Public Health suggests that normal-weight nutrition and exercise counselors report feeling significantly more successful in getting their obese patients to lose weight than those who are overweight or obese.

A report on the findings, published online Sept. 4 in the journal Obesity, suggests that patients may be more receptive to those who "practice what they preach."

"Our research shows that the personal weight of health professionals matters when assessing their perceived level of success in helping obese patients to lose weight," says study leader Sara Bleich, PhD, an associate professor with the Bloomberg School's Department of Health Policy and Management. "Health professionals who maintain a healthy weight feel more empowered to help their obese patients achieve their weight loss goals and reported being more successful at helping obese patients lose weight."

The researchers surveyed 500 non-physician health professionals specializing in nutrition, nursing, behavior/mental health, exercise and pharmacy between January 20 and February 5, 2014. Professionals of all weights, the survey found, were equally confident in their ability to relay proper weight-loss advice and felt that patients were equally receptive to it. But 52 percent of those counselors of normal weight reported success in helping obese patients achieve clinically significant weight loss as compared to 29 percent of overweight counselors.

The study also found that most health professionals, regardless of their weight, do not feel successful in helping patients with weight loss until they are morbidly obese, which suggests missed opportunities for early intervention. Obesity affects one-third of the U.S. adult population and is estimated to cost $147 billion annually, with only about one-third of patients receiving a diagnosis and one-fifth receiving weight-related counseling.

A 2012 study led by Bleich on the impact of physician BMI on obesity care found that size also matters when it comes to physician care of obese patients. It found that normal-weight physicians, as compared to overweight/obese physicians, were more likely to provide recommended obesity care to their patients and feel confident doing so.

"More research is needed to understand how to improve obesity care delivered by non-physician health professionals, and why these groups do not typically initiate weight management discussions until their patients are morbidly obese, regardless of their personal body weight," Bleich says. "Going forward, it will be important to increase the confidence, perception and skill set among all health professionals who work on this public health issue."

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